The effect of self-efficacy expectations in the adherence to a gluten free diet in celiac disease

Objective: To analyse the effect of general and specific self-efficacy on the adherence to a gluten free diet (GFD) in patients with celiac disease along with the effect of other relevant variables.Design: 271 patients with celiac disease participated in this transversal descriptive study and completed a series of questionnaires regarding adherence (CDAT), general self-efficacy (GSES) and specific self-efficacy (Celiac-SE) and quality of life (CD-Qol), among others.Main Outcome Measures: Dependent variable was adherence to the Gluten Free Diet (GFD). Main independent variables were general self-efficacy, specific self-efficacy and quality of life. Model tests were conducted using regression analysis.Results: 71.9% of patients show an excellent or good adherence to the diet. Higher levels of adherence are positively associated to a high expectancy of specific self-efficacy, to the perceived adoption of recommended behaviours, risk perception and better quality of life (these variables accounted for 36.4% of the variance in the adherence to a GFD, p<.001).Conclusions: Specific self-efficacy rather than general has a predictive value in adherence to a GFD. Therefore, we need to develop and transculturally adapt new instruments to assess specific self-efficacy. Celiac-SE has proved to be a useful scale for this objective.